The Pharmaceutical Journal
Vol 272 No 7303 p733
12 June 2004

This article
Reprint   Photocopy

  Acrobat Reader

News summary

Patients with diabetes prefer inhaled insulin over injected insulin

Patients prefer inhaled insulin over the subcutaneous product, according to a study published last week.

A licence application for inhaled insulin (Exubera, Aventis) was submitted to the European regulatory agency early this year but the product has not yet received approval.

The new study, which revealed that patients with type 1 or type 2 diabetes prefer to use inhaled insulin rather than injecting subcutaneously, also showed that glycaemic control is maintained with the inhaled product.

The trial consisted of two 12-week open-label studies and a one-year extension period. Seventy patients with type 1 diabetes and 51 with type 2 disease were randomised between the regimens. In the one-year study patients could choose between inhaled or injected therapy. Of the 60 patients who received inhaled insulin during the first study, 85 per cent chose to continue the treatment while 13 per cent switched to the subcutaneous route. Of the 61 patients who started with subcutaneous insulin, 75 per cent switched to inhaled therapy.

The authors, from the Dallas diabetes and endocrine centre and from Pfizer and Aventis, add that glycated haemoglobin (HbA_1c) reductions were maintained over one year with the inhaled product. Those who switched from injected to inhaled insulin reported improvements in ease of use, “social comfort” and overall satisfaction over the one year study (Diabetes Care 2004;27:1318).

At the American Diabetes Association meeting this week, further data on inhaled insulin (Exubera) were presented. Anthony Barnett, University of Birmingham, reported a pooled analysis of two one-year studies. These involved a total of 627 type 2 diabetes patients poorly controlled on metformin or glibenclamide.

Patients were randomised to either inhaled insulin as adjunctive therapy or to a second oral agent. Professor Barnett said that inhaled insulin was effective and well tolerated, with glycaemic control maintained over the year and the overall rate of hypoglycaemia the same in both groups. Slight changes in lung function were small and non-progressive, he added.

Another study presented at the US meeting found well maintained glycaemic control and pulmonary function in 204 diabetes patients after four years’ continuous therapy with inhaled insulin.